Diabetes

Diabetes mellitus is a disease where there is too much sugar (glucose) in the blood. It is caused by abnormal metabolism of insulin, a hormone that regulates blood sugar in the body. Unless it is treated, diabetes will damage the eyes, kidneys and other important organs in the body.

Diabetes is a major health problem in Malaysia, affecting more and more people each year. In 2015, the Malaysian Health Ministry estimated that 1 out of 6 persons (17.5%) aged 18 years and above had diabetes. Currently, Malaysia has the highest rates of diabetes and obesity in South East Asia, ranking among the highest in the world.

What is Diabetic Retinopathy?

Diabetic retinopathy is a complication of diabetes that can cause blindness. Diabetes damages blood vessels in the light-sensitive nerve layer inside the eye (retina). When damaged blood vessels leak, they cause the retina to swell. They may also get blocked, causing less oxygen to reach the retina. The longer a person has had diabetes, the more likely it is for diabetic retinopathy to develop.

Diabetic retinopathy usually affects both eyes. It is a common cause of poor eyesight in diabetes. It is also a leading cause of blindness among adults of working age.

Watch how diabetes retinopathy affected Johan's life

Types of Diabetic Retinopathy

There are 3 main ways to describe diabetic retinopathy:

1. Non-proliferative diabetic retinopathy (NPDR)

This is an earlier and less severe stage. Blood vessel damage can be seen as areas of bleeding, leaking and swelling on the retina. Patients usually do not notice any eyesight problems at this time.

Healthy retina

2. Proliferative diabetic retinopathy (PDR)

This is a later and more serious stage where abnormal new blood vessels and scar tissue form inside the eye. These new blood vessels break easily, causing bleeding into the eyeball. As the condition gets worse, patients start to have problems with their eyesight. The retina will become permanently scarred if proliferative retinopathy is not detected and treated quickly.

Bleeding and leaking on the retina

3. Diabetic maculopathy

The macula is the vital part of the retina that is responsible for sharp vision. When diabetic retinopathy affects the macula (diabetic maculopathy), patients will find it difficult to read small print or to recognise faces easily.

Bleeding into eye ball

Signs and Symptoms

At first, there are no symptoms and most patients are unaware that they have retinopathy. Later, they may experience: